Bactericidal activity response of blood neutrophils from critically ill patients to in vitro granulocyte colony-stimulating factor stimulation

Kun Yang, Élie Azoulay, Lynda Attalah, Jean Ralph Zahar, Andry Van De Louw, Charles Cerf, Claude James Soussy, Philippe Duvaldestin, Laurent Brochard, Christian Brun-Buisson, Alain Harf, Christophe Delclaux

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11 Scopus citations

Abstract

Objective: Neutrophil function impairment is common in non-neutropenic critically ill patients. Whether granulocyte colony-stimulating factor (G-CSF) may be useful for preventing nosocomial infection in these patients is debated. The response of blood neutrophils from critically ill patients to G-CSF was investigated in vitro. Design and setting: Prospective study, laboratory investigation in two intensive care units. Patients: 52 critically ill patients without immunosuppression. Measurements: Neutrophils obtained from 52 patients on the 5th day of their intensive care unit stay were incubated with and without G-CSF (1, 10, 100 ng/ml). Reactive oxygen species (ROS) release and bactericidal activity against Staphylococcus aureus and Pseudomonas aeruginosa were evaluated. Plasma cytokines (interleukin 10, tumor necrosis factor α, and G-CSF) were measured. Results: Median values (25th-75th percentiles) indicated no stimulatory effect of G-CSF on neutrophil bactericidal activity against either organism: S. aureus, 100% (95-109) of the unstimulated condition with 1 ng/ml G-CSF, and P. aeruginosa, 102% (98-109) with 1 ng/ml G-CSF. However, wide inter-individual variability was found, ranging from marked inhibition to marked stimulation. Similar variability was found for ROS release. No correlations were found between ROS release and bactericidal activities against either bacterial strain. Inhibition of neutrophil bactericidal activity by G-CSF was associated with significantly higher plasma interleukin 10 concentrations. Plasma G-CSF levels were significantly higher in patients whose neutrophil bactericidal activity was unresponsive to G-CSF, suggesting G-CSF receptor downregulation. Conclusions: The effect of G-CSF on in vitro neutrophil bactericidal activity varied widely, depending on endogenous levels of G-CSF and was not predictable based on severity scores.

Original languageEnglish (US)
Pages (from-to)396-402
Number of pages7
JournalIntensive Care Medicine
Volume29
Issue number3
DOIs
StatePublished - Mar 1 2003

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

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